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논문 기본 정보

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저자정보
da Silva Júnior Nilton Rocha (Division of Interventional Neuroradiology Felício Rocho Hospital Belo Horizonte Minas Gerais Brazil) Trivelato Felipe Padovani (Division of Interventional Neuroradiology Felício Rocho Hospital Belo Horizonte Minas Gerais Brazil) Nakiri Guilherme Seizem (Division of Interventional Neuroradiology Hospital das Clínicas Medical School University of São Pa) Rezende Marco Túlio Salles (Division of Interventional Neuroradiology Felício Rocho Hospital Belo Horizonte Minas Gerais Brazil) de Castro-Afonso Luís Henrique (University of São Paulo) Abud Thiago Giansante (Division of Interventional Neuroradiology Hospital Israelita Albert Einstein São Paulo Brazil) Vanzin José Ricardo (Division of Interventional Neuroradiology Hospital de Clínicas Passo Fundo Rio Grande do Sul Brazil) Manzato Luciano Bambini (Division of Interventional Neuroradiology Hospital de Clínicas Passo Fundo Rio Grande do Sul Brazil) Ulhôa Alexandre Cordeiro (Division of Interventional Neuroradiology Felício Rocho Hospital Belo Horizonte Minas Gerais Brazil) Abud Daniel Giansante (Division of Interventional Neuroradiology Hospital das Clínicas Medical School University of São Pa) Giannetti Alexandre Varella (Department of Neurosurgery Hospital das Clínicas Federal University of Minas Gerais Belo Horizonte)
저널정보
대한뇌혈관외과학회 Journal of Cerebrovascular and Endovascular Neurosurgery Journal of Cerebrovascular and Endovascular Neurosurgery Vol.23 No.3
발행연도
2021.9
수록면
221 - 232 (12page)
DOI
10.7461/jcen.2021.E2021.03.001

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Objective Total aneurysm occlusion is crucial for the prevention of rebleeding of a ruptured aneurysm or to avoid rupture of an unruptured lesion. Both surgical and endovascular embolization fail to achieve complete aneurysm occlusion in all the cases. The objective of the study was to establish the safety and efficacy of endovascular treatment for previously clipped residual or recurrent aneurysms. Methods This was an observational, retrospective study of patients harboring incompletely occluded intracranial aneurysms after clipping who underwent endovascular treatment. Patients were treated using 4 different techniques: (1) simple coiling, (2) balloon remodeling, (3) stent-assisted coiling, and (4) flow diversion. Analyses were performed to identify predictors of total aneurysm occlusion, recanalization and complications. Results Between May 2010 and September 2018, 70 patients harboring incompletely occluded intracranial aneurysms after clipping met the inclusion criteria in 5 centers. The mean residual aneurysm size was 7.5 mm. Fifty-nine aneurysms were unruptured. Total aneurysm occlusion was achieved in 75.3% of the aneurysms after 1 year. All aneurysms treated with flow diversion revealed complete occlusion according to control angiography. Recanalization was observed in 14.5%. Permanent morbidity and mortality occurred in 2.9% and 1.4% of the patients, respectively. Conclusions Endovascular treatment of recurrent or residual aneurysms after surgical clipping was safe and efficacious. Flow diversion seems to be associated with better anatomical results. A more rigid study, a larger group of patients, and long-term follow-up are required to provide stronger conclusions about the best approach for residual clipped aneurysms.
#Aneurysm #Clipping #Embolization #Endovascular

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참고문헌 (30)

참고문헌 신청
Brinjikji W / 2011 / Better outcomes with treatment by coiling relative to clipping of unruptured intracranial aneurysms in the United States, 2001-2008 / AJNR Am J Neuroradiol 32(6):1071~1075 google schola David CA / 1999 / Late angiographic follow-up review of surgically treated aneurysms / J Neurosurg 91(3):396~401 google schola Dorfer C / 2012 / Management of residual and recurrent aneurysms after initial endovascular treatment / Neurosurgery 70(3):537~553 google schola Dornbos D 3rd / 2017 / Pipeline embolization device for recurrence of previously treated aneurysms / Neurosurg Focus 42(6):E8 google schola Drake CG / 1984 / Failed aneurysm surgery. Reoperation in 115 cases / J Neurosurg 61(5):848~856 google schola

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